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February 21, 1996

Dear Doctor... Regarding Calcium Channel Blockers-Reply

Author Affiliations

University of Washington Seattle
Bowman Gray School of Medicine Winston-Salem, NC

JAMA. 1996;275(7):518-519. doi:10.1001/jama.1996.03530310023021

In Reply.  —Dr Stryer and colleagues have provided JAMA readers with important background information about the Dear Doctor letter that was sent directly to many US physicians at the time our article was published. We suspect that many clinicians would have interpreted the letter differently if they had known it was solicited by a public relations firm and distributed with drug company sponsorship.Several points in Dr Kaplan's letter deserve comment. First, by saying that "the cases almost certainly had more preexisting coronary risk factors than the controls," Kaplan implies incorrectly that our case-control study was thereby flawed. By definition, patients with myocardial infarction, the cases, will have more risk factors for coronary disease than patients without myocardial infarction, the controls. If our study had been unable to confirm the traditional risk factors for coronary disease in its comparison of cases and controls, the quality and the validity of the